As someone who has poured over the big CMS Medicare Payment data (9 million rows of government data), segments of NCPDP data, and Pharma Voluntary disclosure data, the over-riding impression I have is that it appears to be largely (95-99%) accurate. There are clearly errors, and most of them are obvious and glaring. If there are subtle and minor errors, they wont likely be noticed by anyone, probably including the physicians whose data it is. Having said that, it is clear that in gathering data of this size, and of even relatively modest complexity, there will be errors. These will be fixed, probably not fast enough to satisfy the critics of this process. But the bigger question is can this data be made more granular and in ways that are of benefit to both regulatory agencies, payors, and patients. It reflects a system that may not make much sense at this point anyway. Short of major overhauls in the entire system, the data will not look much different. Like all reporting that takes place, someone needs to explain it in context. That cant be left up to the press, who understands nothing of the US healthcare system that doesnt lend itself to sensational headlines. Physician groups will need to educate their patients and the public in general about the facts of life in healthcare. If they wont, they will be targets. So far the press (national and Propublica) has done a lousy job of separating promotional activities of physicians who contractually are acting as employees of Pharma/MedDev and are paid for those activities, v research, or v. certain independent CME activities. That's a mischaracterization that must not be allowed to continue to exist. As physician driven promotional budgets continue to shrink and the burden of reporting takes an operational toll, reducing these types of activities that require reporting, the headline value will decline. Much of what we see as press "reported" is from activities from a decade or more ago, and much has changed since then, for many reasons. Having said that, Indiana University Medical School hired another 100 research staff (added to the 400+ they have) to obtain more of this funding, as they lay off clinical staff. The entire US healthcare system has been addicted to these funds for decades now. What we havent seen is a straight forward, non-PR generated, educational assessment of how this money benefits the public, and what portion of it may not. Until that happens, this can, and will, all be made to look like a mafia tribute system. And that is not in anyones interest.

4:27 pm July 29, 2014

CollateralAnalyst wrote:

As someone working on this from an institutional perspective, there are plenty of problems with the program, not the least of which is the horrible system implemented to view and dispute disclosures.

On the other hand, the industrial organizations signing this letter should be shamed for not at least making an effort. It is already apparent to physicians who can view and dispute payments they have received what kind of context there will be with the information from the physician side. There is a Payment Category (e.g. General Payments), A payment type (e.g. Cash or Cash equivalent), and a Nature of Payment or Transfer (e.g. Consulting Fee) field. Also there is a yes/no indicator for delay in research publication. Perhaps that isn't sufficient (though I think it's about as good as you can get without having the organization and physicians testify as to each payment), but they should explain why it isn't sufficient if that's the case.

It's hard to take such mighty industry organizations seriously when they haven't done the obvious legwork within the system to actually complain about it.

11:05 pm July 30, 2014

PharmaWatcher wrote:

I wonder if someone can extract the figure that Pharmaceutical Companies, Labs and Medical Device companies have spent on managing this data?

And the public wonders why medical products and services are so expensive in this country. We seriously need to take a closer look at some of these regulations which end up costing payers and consumers.

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